No Surprises Act Botches Our Medical Bills?

Letter Ephesians: Believe it. The “No Surprises Act of 2020” surprisingly triggered a tsunami of surprise medical billings that were arbitrated. Surprised the accused providers are winning the dispute nearly 90% of the time?

Having been a recent medical billing “victim,” I enjoyed reading the WSJ’s “Surprise Billing Racket,” which noted how “Biden officials predicted 17,000 arbitration disputes a year under the No Surprises Act [yet] In 2026 there were 2.6 million … Read on and weep.” In 2019, then-President Trump lamented, “For too long, surprise billings … has left some patients with thousands of dollars of unexpected & unjustified charges for services they did not know anything about.” According to the paper, “Surprise bills usually resulted from patients who received emergency care at hospitals outside their insurance network, or at in-network hospitals that contract with out-of-network providers. Hospitals sometimes employ outside provider groups that can be less expensive than putting physicians on their payrolls.”

Congress’s Surprise Billing Act attached to its December 2020 Covid spending splurge was supposed to solve all that via a new, stream-lined “Baseball-style” arbitration system. But unsurprisingly, we’re now told, the new system may have “ended surprised bills but swelled costs for insurers, which are now being passed along in higher premiums.” What’s worse is that the providers largely control who the arbitrators are, as if this were an MLB contract dispute. And guess who wins 90% of the time? The consumers or the providers? As it happens, my wife recently had an MRI & three months later, the related bills are still coming. One was $219.00 for somebody in the third-party MRI company to “read” the MRI. Read for who? Her doctor? Guess if we’ll go to arbitration and lose?

Davd Soul